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Athletic Training Program Policy and Procedures Manual WEST LIBERTY UNIVERSITY ATHLETIC TRAINING POLICY AND PROCEDURES MANUAL TABLE OF CONTENTS INTRODUCTION .................................................................................................................. 6 A. MISSION STATEMENT:.............................................................................................................7 B. ATHLETIC TRAINING PHILOSOPHY: .........................................................................................7 C. RATIONAL: ..............................................................................................................................8 PROFESSIONAL RESPONSIBILITY ................................................................................. 9 A. NATA CODE OF ETHICS .........................................................................................................10 STANDARDS OF OPERATION .......................................................................................... 12 A. CONFIDENTIALITY AND PRIVACY ............................................................................................13 B. LIABILITY STATEMENT ...........................................................................................................13 D. HOURS OF OPERATION AND CONTACT INFORMATION: ............................................................14 E. SPORT SPECIFIC RESPONSIBILITIES: .......................................................................................16 F. NON-TRADITIONAL SPORT COVERAGE AND GENERAL STUDENT POPULATION: .....................16 G. ATHLETIC TRAINING ROOM GUIDELINES: ...............................................................................16 H. PROFESSIONAL APPEARANCE:.................................................................................................17 CARE AND PREVENTION OF ATHLETIC INJURIES .................................................... 18 A. PRE-PARTICIPATION EXAM: ....................................................................................................19 B. SICKLE CELL: ..........................................................................................................................21 i. Student Sickle Cell Trait Testing Information Sheet .................................................21 ii. Student Sickle Cell Trait Testing Waiver Sheet ........................................................21 C. CONCUSSION MANAGEMENT AND PROTOCOL .........................................................................24 D. EDUCATION.............................................................................................................................24 E. SIGNS AND SYMPTOMS OF A CONCUSSION ..............................................................................24 F. BASELINE TESTING .................................................................................................................25 G. REPORTING A CONCUSSION ....................................................................................................25 H. ACUTE MANAGEMENT OF A CONCUSSION ..............................................................................25 I. POST-ACUTE CONCUSSION MANAGEMENT .............................................................................25 i. Student Athlete Concussion Information Sheet .........................................................26 ii. Coordination of Care for Concussions .......................................................................26 iii. Sideline Concussion Assessment Protocol ................................................................26 iv. Physicians Notification to Instructor about an Athletes Concussion .........................26 J. EQUIPMENT NOTIFICATION: ....................................................................................................31 K. EVALUATION PROCEDURE & DOCUMENTATION .....................................................................31 i. Initial Evaluation/Follow-up Form ............................................................................32 ii. Rehabilitation Sheet ...................................................................................................32 L. MEDICAL REFERRAL GUIDELINES: .........................................................................................37 M. ATHLETIC TRAINING SERVICES: .............................................................................................37 N. i. Agent of Record Statement ........................................................................................38 ii. Visiting Athletic Trainer’s Information Sheet ...........................................................38 THERAPEUTIC EQUIPMENT COMPLIANCE AND SAFETY POLICY: .............................................42 i. Modality Calibration: .................................................................................................42 ii. Modality Problems, Repair, and Safety: ....................................................................42 iii. Cryotherapy: ..............................................................................................................42 iv. Electrical Muscle Stimulation: ...................................................................................43 v. Hydrotherapy: ............................................................................................................44 vi. Intermittent Pneumatic Compression:........................................................................44 vii. Quad-7 Cold and Hot compression: ...........................................................................45 viii. Iontophoresis: .............................................................................................................45 ix. Paraffin:......................................................................................................................46 x. Moist Hot Packs: ........................................................................................................46 xi. Ultrasound/Phonophoresis: ........................................................................................47 HEALTH AND SAFETY ...................................................................................................... 49 A. BLOOD-BORN PATHOGENS: ....................................................................................................50 B. MEDICATION DISTRIBUTION: ..................................................................................................50 i. Prescription Drug Distribution:..................................................................................50 ii. Over the Counter (OTC) Drug Distribution: .............................................................50 C. IV THERAPY: ..........................................................................................................................50 D. TROPICAL ANALGESICS/MEDS: ...............................................................................................51 E. METERED-DOSED INHALERS: ..................................................................................................51 F. EPIPENS: .................................................................................................................................51 G. ACETYLSALICYLIC ACID: ........................................................................................................51 H. DEXAMETHASONE: .................................................................................................................51 I. SUPPLEMENTS: ........................................................................................................................51 J. PREGNANCY:...........................................................................................................................51 K. HEAT ILLNESS: ........................................................................................................................51 L. LIGHTNING SAFETY POLICY:...................................................................................................52 i. M. West Liberty University Lightning Policy.................................................................52 INFECTION CONTROL AND PREVENTION .................................................................................55 EMERGENCY PROCEDURES ............................................................................................ 57 3 A. EMERGENCY ACTION PLANS:..................................................................................................58 OTHER POLICIES AND PROCEDURES ........................................................................... 75 A. PORTABLE RADIO USAGE GUIDELINES: ..................................................................................76 STUDENT HANDBOOK TABLE OF CONTENTS A. WLU Athletic Training Program Mission Statement ................................................. 81 B. WLU Athletic Training Program Outcomes .............................................................. 81 C. Progression in Program............................................................................................... 81 1. GRADE-POINT REQUIREMENTS ...............................................................................................81 2. STUDENT PRE-CLINICAL PHYSICALS ......................................................................................81 3. CLINICAL ROTATIONS .............................................................................................................82 4. D. E. a. AT 200 Athletic Training Clinical Practicum I – 1 hour ...........................................82 b. AT 205 Athletic Training Clinical Practicum II– 1 hour...........................................82 c. AT 300: Athletic Training Clinical Practicum III – 2 hours ......................................82 d. AT 305: Athletic Training Clinical Practicum IV – 2 hours .....................................83 e. AT 400: Athletic Training Clinical Practicum V – 2 hours .......................................83 f. AT 405: Athletic Training Clinical Practicum VI – 2 hours .....................................83 CLINICAL HOURS POLICY .......................................................................................................84 Attendance Policy ....................................................................................................... 84 1. CLASS ATTENDANCE ..............................................................................................................84 2. CLINICAL ATTENDANCE..........................................................................................................84 a. Excused Absences ......................................................................................................84 b. Unexcused Absences .................................................................................................85 c. Calling off during your clinical rotation ....................................................................86 d. Clinical Tardiness ......................................................................................................86 e. Expected Hours of Work ...........................................................................................86 f. Make-up Time ............................................................................................................86 g. Illness during Clinical Attendance .............................................................................87 h. Injury during Clinical Attendance .............................................................................87 i. Extended Illness/Injury Policy ...................................................................................87 j. Inclement Weather Policy ..........................................................................................88 Composite Clinical Performance Evaluation ............................................................. 88 1. GRADING ................................................................................................................................88 4 F. a. Student Notebooks .....................................................................................................88 b. Clinical Academic Assignments ................................................................................89 c. Final Evaluation Forms ..............................................................................................89 d. Cheating and Plagiarism ............................................................................................89 Clinical Rotation Rules and Guidelines...................................................................... 91 1. APPEARANCE/DRESS CODE.....................................................................................................91 2. SPECIFIC RULES AND REGULATIONS .......................................................................................93 3. IMPAIRED THINKING ...............................................................................................................93 a. G. H. I. Drug/Alcohol Use ......................................................................................................93 4. CRIMINAL BACKGROUND CHECK............................................................................................94 5. PREGNANCY POLICY ...............................................................................................................94 6. INFECTIOUS DISEASE POLICY ..................................................................................................94 7. HIPAA TRAINING ...................................................................................................................94 8. UNIVERSAL PRECAUTIONS ......................................................................................................94 9. CPR CERTIFICATION ...............................................................................................................96 10. HEALTH INSURANCE ...............................................................................................................96 Additional Costs ......................................................................................................... 96 1. MALPRACTICE INSURANCE .....................................................................................................96 2. STUDENT TRANSPORTATION ...................................................................................................96 3. STUDENT HOUSING .................................................................................................................96 General Information/Activities ................................................................................... 96 1. STUDENT EMPLOYMENT .........................................................................................................97 2. ATHLETIC PARTICIPATION ......................................................................................................97 3. ATHLETIC SEASON ..................................................................................................................97 4. STUDENT HEALTH REPORTING POLICY ...................................................................................97 5. PROFESSIONAL ASSOCIATION MEMBERSHIP ...........................................................................97 Disciplinary Procedures .............................................................................................. 98 1. FIRST OFFENSE: ......................................................................................................................98 2. SECOND OFFENSE: ..................................................................................................................98 3. THIRD OFFENSE: .....................................................................................................................98 a. Permanent Dismissal from a Clinical Site .................................................................98 J. NATA Code of Ethics ................................................................................................ 100 K. STUDENT POLICIES AGREEMENT ...................................................................... 102 5 INTRODUCTION A. MISSION STATEMENT: Athletic Training is a health care profession that specializes in preventing, recognizing, managing, and rehabilitation injuries. In cooperation which physicians, other allied health personnel, administration, coaches, parent, and the student-athlete, the Athletic Trainer functions as an integral member of the health care team at West Liberty University. The health and safety principle of the National Collegiate Athletic Association's constitution provides that it is the responsibility of each member institution (WLU) to protect the health of, and provide a safe environment for, each of its participating student-athletes. Therefore, the mission of West Liberty Athletic Training should be to ensure the health and welfare of each student-athlete participating in varsity athletics at WLU. Additionally, West Liberty University Athletic Training should seek to educate the student-athletes, athletic training students, coaches, administrators, and public about the profession of Athletic Training, appropriate care for conditions and injuries, and rehabilitation needed for specific injuries. Athletic Trainers at West Liberty University should be highly motivated individuals. They should constantly seek out all available knowledge relating to the profession. They should maintain a professional health care environment for the student-athlete. West Liberty University Athletic Trainers must adhere to the National Athletic Trainers' Association Code of Ethics and the Rules and Regulations set forth by the West Virginia Board of Physical Therapy for Registered Athletic Trainers in the state. B. ATHLETIC TRAINING PHILOSOPHY: The West Liberty University Athletic Training Staff must work as a team. The team is directed by the Team Physician. As allied healthcare professionals, athletic trainers are providers of sports injury care and are educators of health, fitness, nutrition, and medicine. The athletic trainer(s) at West Liberty University must maintain integrity, confidentiality, enthusiasm, and charismatic dedication through their medical training and value system. These qualities are not only learned but are embedded within the soul of the healthcare provider. It is the belief of this institution that athletic training services are an integral part of athletic health and medicine. It is also believed that athletic trainers play a major role in the development of the individuals they serve. First, by preventing hardship or injury by taking precautions, such as scanning the field before play or checking the heat index for dangerous environmental conditions. Second, by recognizing and treating injures quickly and efficiently. This should not only be addressed by assessing the injury, but also by treating the athletics' mental, emotional and spiritual needs. Third, by providing rehabilitation to the athlete in a consistent and functionally progressive manner. Teaching the athletes home exercises will give them a sense of ownership and accomplishment. Fourth, by administering the sports medicine program to accomplish organization, formulation of action plans and standard operating procedures. This will develop consistency and accountability. Lastly, athletic trainers must continue professional development, responsibility, and strong work ethic. All athletic trainers need to be lifelong learners and educators. This will better prepare them for caring for the unique conditions, while giving our athletes and patients basic knowledge of their pathology that will spark their curiosity. 7 C. RATIONAL: The following are rationale for implementing a Policy & Procedures for WLU Athletic Training: To provide the intercollegiate community with pertinent information regarding the operating policy and procedures of the West Liberty University Athletic Training Program. To ensure there is a system checklist in place for workers and supervisors to provide consistent and accurate performances that do not harm involved individuals. To ensure procedures are followed based upon national, state, departmental, and governmental regulations regarding athletic training services and emergency procedures. To serve as a day-to-day procedural steps that should be utilized by West Liberty Athletic Trainers, Team Physicians, and Athletic Training Students under the supervision of a Preceptor. 8 PROFESSIONAL RESPONSIBILITY 9 A. NATA CODE OF ETHICS PREAMBLE September 28, 2005 The National Athletic Trainers’ Association Code of Ethics states the principles of ethical behavior that should be followed in the practice of athletic training. It is intended to establish and maintain high standards and professionalism for the athletic training profession. The principles do not cover every situation encountered by the practicing athletic trainer, but are representative of the spirit with which athletic trainers should make decisions. The principles are written generally; the circumstances of a situation will determine the interpretation and application of a given principle and of the Code as a whole. When a conflict exists between the Code and the law, the law prevails. PRINCIPLE 1: Members shall respect the rights, welfare and dignity of all. 1.1 Members shall not discriminate against any legally protected class. 1.2 Members shall be committed to providing competent care. 1.3 Members shall preserve the confidentiality of privileged information and shall not release such information to a third party not involved in the patient’s care without a release unless required by law. PRINCIPLE 2: Members shall comply with the laws and regulations governing the practice of athletic training. 2.1 Members shall comply with applicable local, state, and federal laws and institutional guidelines. 2.2 Members shall be familiar with and abide by all National Athletic Trainers’ Association standards, rules and regulations. 2.3 Members shall report illegal or unethical practices related to athletic training to the appropriate person or authority. 2.4 Members shall avoid substance abuse and, when necessary, seek rehabilitation for chemical dependency. PRINCIPLE 3: Members shall maintain and promote high standards in their provision of services. 3.1 Members shall not misrepresent, either directly or indirectly, their skills, training, professional credentials, identity or services. 3.2 Members shall provide only those services for which they are qualified through education or experience and which are allowed by their practice acts and other pertinent regulation. 3.3 Members shall provide services, make referrals, and seek compensation only for those services that are necessary. 3.4 Members shall recognize the need for continuing education and participate in educational activities that enhance their skills and knowledge. 3.5 Members shall educate those whom they supervise in the practice of athletic training about the Code of Ethics and stress the importance of adherence. 3.6 Members who are researchers or educators should maintain and promote ethical conduct in research and educational activities. 10 PRINCIPLE 4: Members shall not engage in conduct that could be construed as a conflict of interest or that reflects negatively on the profession. 4.1 Members should conduct themselves personally and professionally in a manner that does not compromise their professional responsibilities or the practice of athletic training. 4.2 National Athletic Trainers’ Association current or past volunteer leaders shall not use the NATA logo in the endorsement of products or services or exploit their affiliation with the NATA in a manner that reflects badly upon the profession. 4.3 Members shall not place financial gain above the patient‘s welfare and shall not participate in any arrangement that exploits the patient. 4.4 Members shall not, through direct or indirect means, use information obtained in the course of the practice of athletic training to try to influence the score or outcome of an athletic event, or attempt to induce financial gain through gambling. 11 STANDARDS OF OPERATION 12 A. CONFIDENTIALITY AND PRIVACY: At West Liberty University, protecting the confidentiality of injured and ill athletes and their medical records is of utmost concern and an important component in the success of our services. We take appreciable measures to ensure that the privacy rights of our athletes are protected and that all the state and federal laws protecting those rights are adhered to by the athletic training staff. Please refer to the University's documentation as it pertains to HIPAA and FERPA. B. LIABILITY STATEMENT: The Athletic Training Staff, including Athletic Training Students, have immediate cell phone access in the event emergency services need to be contacted. During home contests Athletic Trainers also have access to portable radios so they can be in direct contact with Campus Police and local EMS. Football games will always have access to the portable radio and other home contests will depend on accessibility of radio. The Certified Athletic Trainers on staff recertify in basic life support and first aid bi-annually. They also complete at minimum 75 hours of continuing education during every three-year reporting period. A team physician is on site for all home football games. A nurse is available at Health Services Monday through Friday during normal business hours. Five full-time Athletic Trainers are available during the business day and are assigned sport coverage based on injury rates and the possibility of significant injury. An athletic trainer travels with football and basketball for all contests and is assigned to football during all contact practices during their traditional and spring season. Athletic trainers are assigned to basketball practices as well. The Athletic Training staff ensures that each team traveling without an athletic trainer has a stocked medical kit. The medical kit contains first aid supplies and emergency contact information of the athletes. The Athletic Training Staff maintains AED supplies and equipment in the event of an emergency. The Athletic Training Staff monitors inclement weather and makes decisions that provide for the health and safety of all athletes. All athletes are required to maintain their own medical insurance that will cover athletic related injuries. Those with inadequate insurance will not be permitted to participate in any team activity (games, practices, off season conditioning, etc.) West Liberty University is not responsible for any cost incurred by the athlete while participating in intercollegiate athletes. An associate from the Riddell Company fits the football team with protective equipment annually. During practice and competition, athletes have direct access to an unlimited supply of water. When temperatures and relative humidity are high enough to potentially case heat related illness the athletic training staff provides Gatorade for electrolyte replacement and iced towels to cool the temperature of overheated athletes. The Athletic Training Staff displays NCAA posters and American Heart Association posters used for educational purposes. Information on the posters may be used to: 1) Reduce risk of infection, 2) Reduce risk of 13 environmental exposure, and 3) Treat victims of life threatening events D. HOURS OF OPERATION AND CONTACT INFORMATION: The Main Athletic Training Room is open Monday through Friday, 9:30 am-3:00 pm. An athletic trainer will be around between the hours specified during the week. The operating hours are posted on the door of the Athletic Training Room and may be subject to change due to inclement weather, sport season, sport travel, academic teaching, etc. 14 Athletic Training Program Director: Dr. David R. Hanna PT, DPT, PT, ATC (O) 304-336-8547 Head Athletic Trainer Herb Minch MS, ATC (O) 304-336-8476 Athletic Trainer Jason Coleman MS, ATC (O) 304-336-8093 Faculty/Athletic Trainer Jerry Duncan MS, ATC, CES (O) 304-336-8651 Faculty/Athletic Trainer Hannah Harnar MS, ATC (O) 304-336-8650 Athletic Trainer Amber Helphenstine, ATC (O) 304-336-5468 15 E. SPORT SPECIFIC RESPONSIBILITIES: Sport Direct Supervision Indirect Supervision Football Jerry Duncan Jerry Duncan Volleyball Amber Helphenstine Amber Helphenstine Men’s Cross Country Jerry Duncan Hannah Harnar Women’s Cross Country Jerry Duncan Hannah Harnar Men’s Golf Amber Helphenstine Women’s Golf Amber Helphenstine Travel Men’s Tennis Amber Helphenstine Women’s Tennis Amber Helphenstine Men’s Basketball Jason Coleman Jason Coleman Women’s Basketball Jerry Duncan Hannah Harnar Jerry Duncan Hannah Harnar Wrestling Amber Helphenstine Amber Helphenstine Baseball Jason Coleman Jason Coleman Softball Amber Helphenstine Amber Helphenstine Men’s Track and Field Jerry Duncan Hannah Harnar Women’s Track and Field Jerry Duncan Hannah Harnar Women’s Soccer Jason Coleman Jason Coleman F. NON-TRADITIONAL SPORT COVERAGE AND GENERAL STUDENT POPULATION: West Liberty Athletic Trainers will provide no coverage to sports not classified as Varsity Athletics. Certified Athletic Trainers may act as first responders should an injury occur. Care should be limited to basic first aid. Injuries that occur in this situation should be referred to Student Health. If an emergency situation occurs, a responsible party should activate EMS by calling 911 or Campus Police at 304-336-8021. G. ATHLETIC TRAINING ROOM GUIDELINES: Athletes must report for treatments in a reasonable amount of time. No rushed treatments will be provided. Athletes that have class schedules that conflict with treatment times should inform a member of the staff so that appropriate accommodations can be made. Athletes must report for treatments in proper attire. Proper attire for athletes should be athletic shorts, shirts (tank tops, t-shirts, etc), athletic shoes and socks. Athletes are required to shower prior to receiving treatments. Athletes and Athletic Training Students are prohibited from performing modalities other than cryotherapy/thermotherapy without the direct supervision of a Certified Athletic Trainer. 16 It is the athlete’s responsibility to report any injury/condition to a member of the staff. Any athlete that wishes to see a physician should notify a staff member for proper referral. Athletes must sign in when they receive treatment. The Athletic Training Clinic is a professional medical service facility. Loud, rude, or unprofessional behavior (including but not limited to language, gestures, music, etc) will not be tolerated. Disrespect of the Athletic Training Staff, in any form, will not be tolerated. Offending athletes will be dismissed from the Athletic Training Clinic immediately and their coach will be notified. The Athletic Training Clinic is not a lounge or locker room. Any athletes lounging about will be asked to leave. The Athletic Training Staff is not responsible for personal items that have been left in the clinic and have been lost or stolen. You have a locker, use it! Athletes and coaches are not permitted to remove coolers, ice chests, or water bottles from the Athletic Training Clinic without prior approval from a member of the staff. Athletic Trainers and team physicians will determine the proper care and treatment for all athletic related injuries and illnesses. H. PROFESSIONAL APPEARANCE: As an Athletic Trainer, you represent both West Liberty University and the profession of Athletic Training. You are expected to dress and conduct yourself in a professional and responsible manner. Your clothing is to be appropriate and in accordance with professional standards. You must wear appropriate clothing at all times. 1. Wear WLU clothing purchased and provided to you unless otherwise designated by the Head Athletic Trainer. Additional attire must conform to the institution’s color schemes 2. No shirts, dresses, or low-cut fitting shirts. 3. Shoes worn should be safe and comfortable. Sandals, flip-flops, clogs, slippers, open-toed shoes, or heels are not permitted. Stocks or socks must be worn at all times. Open-toes shoes worn as a part of a formal outfit are permitted if appropriate. 4. Appropriate undergarments must be worn at all times and not visible. 5. If shorts are allowed, they must be (golf short-type by design) and appropriately long enough. 6. No holes in any clothing. 7. Shirts tucked in and belts are highly recommended. 8. Hair must be neat and clean. If shoulder length or longer, hair must be pulled or back with a hair clasp. Hair must not come in contact with patients. Beards, moustaches and sideburns must be neat and trimmed. 9. Jewelry should not be excessive. Earrings, rings and necklaces should be kept to a minimum. Only small earrings may be worn. 10. Cosmetics must convey a professional appearance. Make-up should not be excessive. The length of fingernails must promote patient and employee safety. Nail polish must be appropriate and in good repair. 11. No hats to be worn during inside event coverage. 17 CARE AND PREVENTION OF ATHLETIC INJURIES 18 A. PRE-PARTICIPATION EXAM: The West Liberty University Health Services Staff, organize, schedule and perform athletic physicals for 16 varsity intercollegiate sports programs. At the beginning of the academic year, before the start of official practice, health services will schedule individual teams a specific day and time range to perform physicals. The physicals include assessment of height, weight, resting heart rate, temperature, blood pressure, heart/lung sounds, past history information, orthopedic screening, and ImPact baseline testing. The ImPact test is a tool that measures a brain’s function in a variety of different ways. In the event of the concussion, a post traumatic ImPact test can be compared with a baseline test to scientifically ascertain severity of cerebral injury. (Head injuries are also evaluated by the Athletic Training Staff) All information between health services and athletic training is shared. However, the athletic training staff requires different forms to be completed prior to the start of each year. 19 20 B. SICKLE CELL: Sickle cell test results are required to be on file in Division I, II and III institutions. If the student-athletes have been tested and/or have the results, a copy needs to be on file. In the occurrence of an athlete not being tested for sickle cell, they need to be screened through a simple blood test. If the student-athlete does not want to be screened for the sickle cell trait a sign waiver needs to be completed and on file. i. ii. Student Sickle Cell Trait Testing Information Sheet Student Sickle Cell Trait Testing Waiver Sheet 21 22 23 C. CONCUSSION MANAGEMENT AND PROTOCOL A concussion is frequently defined as a head injury with a temporary loss or alteration to brain functions. The changes can exhibit a variety of physical, cognitive, and emotional symptoms, which may not be recognized if subtle. The terms mild brain injury, mild traumatic brain injury (MTBI), mild head injury (MHI), minor head trauma, and concussion may be used interchangeably. A concussion is commonly thought to be caused by impact forces, in which the head strikes or is struck by something, or secondary forces, in which the head moves without itself being subject to blunt trauma (for example, a hard blow to the body which jars the brain inside the skull). A concussion can range from mild to very severe symptoms depending on the individual and the amount of damage caused. Concussions are recognized as being a potentially very serious condition that if managed improperly, can lead to catastrophic consequences. The following policy has been adopted by West Liberty University Athletic Training in an effort to provide a consistent management approach to any student athlete that suffers a concussion, while also recognizing that each concussion, as well as each athlete, is unique and individualized in nature. At West Liberty University, we take great pride in providing optimal health care to all student-athletes. By managing concussions individually, and considering the athlete's medical history, it allows the physicians and athletic trainers on staff to ensure the safety for each student athlete. A concussion is, like many other injuries, not exclusive to sports participation. Any concussion, sports related or not, will be subject to the requirements for return to play outlined in the rest of this policy. This policy includes, but is not limited to the management principles mandated by the NCAA and NATA. D. EDUCATION Student-athletes and coaches will be educated about how to recognize the signs and symptoms of concussions. At West Liberty University, this will be done with every athlete and coach annually at the beginning of the fall semester, or at which point they transfer to WLU and begin to participate in or coach athletics. Two double sided informational sheets will provide education defining concussion, listing symptoms, and explain the recovery process. One of the sheets they will keep for their own reference, the other one they will sign and return to the athletic training staff acknowledging that they have received education on and understand the concussion information that they are presented with. Every athlete and coach has the right to review the policy with a member of the athletic training staff upon request. E. SIGNS AND SYMPTOMS OF A CONCUSSION Signs and symptoms of a concussion may include, but are not limited to the following: Amnesia Sensitivity to light or noise Confusion Nausea (feeling that you might vomit) Headache Feeling sluggish, foggy or groggy 24 Loss of consciousness Feeling unusually irritable Balance problems or dizziness Difficulty getting to sleep or disrupted sleep Double or fuzzy vision Slowed reaction time Concentration or memory problems (forgetting game plays, facts, meeting times) Exercise or activities that require a lot of concentration may cause symptoms to re-appear or worsen, thus increasing the time one needs to recover from a concussion. F. BASELINE TESTING Each athlete at West Liberty University, as part of a comprehensive pre-participation physical exam, will be tested with a computerized neuro-cognitive exam (ImPACT). This test provides a baseline of the neurocognitive functioning of each athlete’s brain at a time where a concussion is not present. This baseline can then be used to identify any cognitive deficiencies after an athlete sustains a concussion. G. REPORTING A CONCUSSION Anyone that suspects a student athlete has a concussion, or notices any athlete suffering from any symptoms of a concussion, must report the concerns to the appropriate member of the West Liberty University Athletic Training Staff. H. ACUTE MANAGEMENT OF A CONCUSSION Any student-athlete that exhibits signs, symptoms, or behaviors consistent with a concussion shall be removed from athletic activity by a member of the athletic training staff, a member of the coaching staff, or by the student-athlete him/herself and shall not return to participation for the remainder of that day. Upon removal, the student-athlete will be evaluated by a member of the athletic training staff using a combination of a symptoms checklist, balance assessment, and neurocognitive testing. Following evaluation, the athletic training staff will determine if further diagnostic testing and transfer to a hospital is warranted by monitoring for deterioration of mental and physical state. When no referral to hospital is made, instructions will be provided to the studentathlete for monitoring by a roommate, teammate, or guardian. I. POST-ACUTE CONCUSSION MANAGEMENT Follow-up Physician care will be determined on an individual basis as directed by the West Liberty Athletic Training Staff. ImPACT testing will be performed as determined by the Athletic Training Staff based on the individual, and their symptoms. Testing will be performed on a schedule as determined by their athletic training staff based on the level of cognitive impairment and symptoms. A "symptom score" shall be taken each day up to, and including the day the student-athlete is completely asymptomatic. Once a student-athlete has been asymptomatic for at least 24 hours and the neuro-cognitive test scores have returned to the baseline scores, a gradual return-to-play protocol shall be implemented, unless directed otherwise by a Physician. 25 1. Complete Rest. Remove athlete from classes and study to allow symptoms to go away. Reevaluate using ImPACT. Progress under direction of a physician when asymptomatic and test scores have returned to baseline level. 2. Light Cardiovascular Exercise without the return of symptoms (50-60% of Maximum Heart Rate) 10 Minutes 3. Moderate Cardiovascular Exercise without the return of symptoms (60-70% of Maximum Heart Rate) 10 Minutes 4. High intensity Cardiovascular Exercise without symptom return (70-85% of Max Heart Rate) 15 Minutes 5. Non-Contact Practice Participation without the return of symptoms 6. Full-Contact Practice Participation without the return of symptoms 7. Return to Full-Participation i. ii. iii. iv. Student Athlete Concussion Information Sheet Coordination of Care for Concussions Sideline Concussion Assessment Protocol Physicians Notification to Instructor about an Athletes Concussion 26 27 28 29 30 J. EQUIPMENT NOTIFICATION: Rules that govern mandatory equipment use vary by sport. The West Liberty University Athletic Training Staff and other athletics personnel are familiar with what equipment is mandatory and what is illegal. Rules Governing Special Protective Equipment Baseball -None Basketball -Rigid substances worn on the elbow, hand, finger, wrist or forearm are prohibited. Flexible material covered with 1/2 inch thick foam may be used to protect or immobilize injury on the aforementioned areas. Equipment that could cause injury to another player is prohibited whether rigid or not. Equipment that the referee believes is dangerous may not be worn. Football -Artificial limp prostheses are prohibited. Hard and abrasive materials worn on the hand, wrist, forearm or elbow must be completely covered by 1/2 inch thick foam. Knee braces must be worn under the pants and entirely covered from direct external exposure. Projection of metal or other hard substance from uniform or person is also prohibited. Soccer -A player may not wear anything that is dangerous to another player. Metal on knee braces may not be exposed. Casts are permitted as long as they are covered and not considered dangerous. No jewelry is permitted unless it is a medical alert bracelet or necklace, which needs to be taped on the body. Softball-Casts, braces, splints, etc. must be completed padded and be neutral in color. If worn by a pitcher it must not be distracting, cause safety risk or give an unfair advantage. Swimming and Diving -None Track and Field -No taping of any part of the fingers, thumb or hand in throwing events is allowed unless it is to cover an open wound. The only exception is during the hammer throw. These tape jobs must be shown to the head judge prior to competition. Forearm covers in the pole vault are permissible to prevent injuries. Volleyball -It is forbidden to wear any object that may cause an injury or give artificial advantage to a player. Hard splints on the hands or arms are prohibited unless padded on all sides by at least 1/2 inch thick slow rebounding foam. All jewelry must be removed. Taping earrings is not permitted. K. EVALUATION PROCEDURE & DOCUMENTATION Once an athlete has sustained an injury a thorough assessment must be performed. The athletic training staff will generally evaluate injuries in accordance with the national orthopedic guidelines. The order in which the athlete may be assessed is shown below. • • • • • • Determine the cause of injury Determine the event of insult Identify the chief complaint Identify other symptoms Discuss pertinent past history Observe signs 31 • • • • • • • • • Observe athlete's movements Identify allergies, medications, diseases Palpate structures Assess range of motion (AROM/PROM/RROM) Manually assess muscle strength Perform special tests Perform neurological tests Assess reflexes and balance Refer to sub-specialist if appropriate As of August 2008, the West Liberty University Athletic Training Staff will document injuries using the Athletic Training System (ATS) Software by Keffer Development, LLC. This software package includes databases for athlete information, injury evaluations and progress note updates, treatment regimens, and medication information, as well as, physician orders, referrals, surgery, physicals, patient history, inventory, and equipment databases. The injured athlete's information will be processed based on the following cases: significant injury, referral to another medical professional, and if lost playing time is a factor. Release of medical information may be required during these situations. Paper documentation will be used as a back-up system. i. ii. Initial Evaluation/Follow-up Form Rehabilitation Sheet 32 33 34 35 36 L. MEDICAL REFERRAL GUIDELINES: The athletic training staff must refer athletes with a significant injury to a specialist and illnesses to the health center. Health Services must refer to the appropriate sub-specialist when required for definitive diagnoses. The goal of referral is to ensure that the athlete receives the most effective care possible. The athletic training staff may refer directly to Doctor’s Urgent Care. Dr. Derrick Eddy, is the West Liberty University Team Physician and is located at Wheeling Hospital. All injures will be referred to him unless an athlete wants to see their primary care physician. If an athlete chooses to see another physician the final return to play clearance must be given by Dr. Derek Eddy, or his appointee, in order for the athlete to resume participating in his/her sport. M. ATHLETIC TRAINING SERVICES: West Liberty University Athletic Training provides the following services to athletes. Basic First Aid: PRICE (protection, rest, ice, compression, elevation) Bandaging Splinting Taping/Bracing Wound Care Assessment of Vital Signs Modality Services: Therapeutic Ultrasound Electrical Muscle Stimulation Phonophoresis Paraffin Therapy Iontophoresis Laser Therapy Manual Services: Joint Mobilizations Trigger Point Therapy Muscle Release Soft tissue massage Cross friction massage Proprioceptive Neuromuscular Facilitation Cervical and Lumbar Traction Hydrotherapy: Thermotherapy: Topical Analgesics Moist hot packs Paraffin therapy Therapeutic Exercise: Conditioning Core Stability Strengthening Stretching Range of Motion Emergency Services: Epi-pens Bronchodilators Splinting/spine boarding Cranial Nerve Assessment CPR/AED Supportive Services: ImPact Testing Nutritional advice Counseling Body weight assessment Body fat assessment 37 Cold Whirlpool Warm Whirlpool Hot Whirlpool Immersion bath Cryotherapy: Ice (bags, packs) Ice Massage Iced towels Immersion bucket Cryokinetics i. ii. Referral Services: Student Health Services Wheeling Hospital ER Ohio Valley Medical Center ER Doctor’s Urgent Care Dr. Derrick Eddy-Wheeling WVU Sports Medicine Center Agent of Record Statement Visiting Athletic Trainer’s Information Sheet 38 DEPARTMENT OF ATHLETICS 208 UNIVERSITY DR. COLLEGE UNION BOX 103 WEST LIBERTY, WV 26074 OFFICE: 304-336-8093 FAX: 304-336-5239 AGENT OF RECORD STATEMENT To Whom It May Concern: I, Dr. Derrick Eddy State License #__________________________________, do hereby grant the following action to the athletic training staff members listed below: David Hanna, PT, DPT, MS, ATC Herb Minch, MS, ATC Amber Helphenstine, ATC Jason Coleman, MS, ATC Jerry Duncan, MS, ATC, CES Hannah Harnar, MS, ATC I permit the above listed members of West Liberty University Athletic Training, to act as my agents, as if they were employees under my supervision and guidance to assist me with the medical care and treatment of WLU student-athletes. The Athletic Trainer/Agent is limited to my specific needs and may include other services: Athletic Trainers/Agents are to use better judgment and knowledge when performing relocation of most joints excluding the hip and spinal vertebrae and to report all relocations without referral to me. - Athletic Trainers/Agents are to use better judgment and knowledge when performing Concussion Management and refer properly for follow-up as per University concussion management guidelines. - Athletic Trainers/Agents are to use better judgment and knowledge when performing the scheduling of MRI via request of physician. Athletic Trainers/Agents are to use better judgment and knowledge when performing the removal of sutures. - Athletic Trainers/Agents are to use better judgment and knowledge when performing treatment and rehabilitation on minor muscle strains, sprains, or other injuries not typically needing referral for physician care. Dr. Derrick Eddy, MD Team Physician Date 39 DEPARTMENT OF ATHLETICS 208 UNIVERSITY DR. COLLEGE UNION BOX 103 WEST LIBERTY, WV 26074 OFFICE: 304-336-8093 FAX: 304-336-5239 DATE: TO: FROM: RE: August 26, 2015 Visiting Athletic Trainers West Liberty Athletic Training Staff Athletic Training Services On behalf of West Liberty University, we would like to welcome you to our campus during the 2015-2016 athletic year. If your team(s) will not be traveling with a Certified Athletic Trainer, we ask that you please send a stocked kit and a letter detailing what treatment they are to receive. We also ask that you notify us either by phone or email 24 hours in advance to discuss treatment for your athletes. During your visit, the following services will be provided to you: 1. Access to our Athletic Training Facilities on the 2nd level of the Academic, Sports, and Recreation Complex (ASRC) located adjacent to West Stadium or in the Soccer Athletic Training Facility located adjacent to the soccer field. 2. Ice, Water, Cups. 3. Use of therapeutic modalities by a Certified Athletic Trainer or with permission of an Athletic Trainer. 4. Access to Emergency Medical Services 5. Access to emergency supplies (spine board, splints, AED, etc.) 6. Access to Team Physician for evaluations (football only) IMPORTANT PHONE NUMBERS: Herb Minch, MS, ATC Head Athletic Trainer [email protected] office: 304-336-8476 cell: 304-639-0183 Jerry Duncan, MS, ATC, CES Faculty/Athletic Trainer [email protected] office: 304-336-8651 cell: 304-231-8281 Amber Helphenstine, ATC Athletic Trainer [email protected] office: 304-336-5468 cell: 304-639-5342 Jason Coleman, MS, ATC Athletic Trainer [email protected] office: 304-336-8093 cell: 304-312-8463 Local Hospitals: Wheeling Hospital 1 Medical Park Wheeling WV, 26003 Ohio Valley Medical Center (OVMC) 2000 Eoff Street Wheeling WV, 26003 Please feel free to contact us with any questions or concerns for your visit to West Liberty 40 University. 41 N. THERAPEUTIC EQUIPMENT COMPLIANCE AND SAFETY POLICY: The West Liberty University Athletic Training Program has a variety of treatment modalities for injured athletes and for the educational benefit of athletic training students under the supervision of certified athletic trainer or preceptors. Items such as modality calibration, safety and repair are discussed below. Also included are detailed lists of treatment protocols for individual modalities including indications and contraindications for use. (Protocols are referenced from current research and practices outlined in: Michlovitz SL, Bellew JW, Nolan TP Jr. Modalities for Therapeutic Intervention. 5th Edition. Philadelphia, PA. F.A.Davis Company; 2012.) All students are required to follow these guidelines at West Liberty University clinical sites and any other off campus clinical site without a policy of its own. i. Modality Calibration: West Liberty University electrical modalities are calibrated annually by a certified calibration technician. ii. Modality Problems, Repair, and Safety: Any problems identified by athletic training students or staff with any electrical modality are reported to the Head Athletic Trainer immediately. Any modality with a suspected dysfunction is removed from use until the problem is corrected. If the electrical modality requires further repair the Head Athletic Trainer will contact a qualified technician to arrange repair. Ground Fault Circuit Interrupters breakers are connected to all outlets in the Athletic Training room to ensure the safety of all modalities from electric shock. Every Athletic training student must receive didactic education on each modality before they are allowed to clinically apply them under supervision. Athletic Training Students are not permitted to use any modality without supervision. iii. Cryotherapy: Cryotherapy is a medical term used to describe the use of cold modalities for the purpose of treating athletes with a variety of conditions. Treatment time varies based upon the modality employed. Ice cup, commonly referred to as ice massage has treatment time of 5-1 0 minutes. The frozen ice is applied directly to the skin with firm pressure. The technique may either be a circular or longitudinal. Each motion must overlap the previous by half (often called half over half). A cold whirlpool may be applied for 10-20 minutes at temperatures ranging from 32-80 degrees Fahrenheit. The foot is immersed in water and a turbine motor agitates the water. An ice pack or ice bag may be applied for as few as 15 and as long as 30 minutes, except in special circumstances. A barrier, such as a towel must be used when commercial packs are applied. Ice bags may be held or wrapped directly to the skin. Indications Spasticity Acute inflammation 42 Fever reduction Localized burns Edema Contraindications Cardiac dysfunction Open wounds Athletes hypersensitive to cold Athletes with anesthetic skin Athletes with regenerating peripheral nerves iv. Electrical Muscle Stimulation: Electrical Muscle Stimulation (EMS) is an effective way to treat certain muscle and joint injuries. Through the use of an external electrical impulse and depending on the parameters, it can aid muscle healing through relaxation, decrease pain, decrease swelling, increase muscle tone/contractibility, and decrease atrophy. There are a variety of different types including: Interferential Current (IFC), Pre-Modulated (Premod), Biphasic, Monopolar High Volt, Russian, Micro-Current etc. IFC is the current of choice to reduce pain. Both channel 1 and channel 2 must be used. Four electrodes are firmly places around the injury. A fixed or sweeping current may be used. General treatment time is 20 minutes. Either cold or heat therapy may be used with IFC depending on what the treatments desired outcome is and what stage of healing the athlete is in. This is up to the discretion and expertise of each athletic trainer. PreMod is similar to IFC only it uses one channel only. The two electrodes are firmly placed proximal and distal to the injury. Biphasic and monopolar are similar to PreMod. Russian EMS is unique and intense. It is used for muscle re-education, increasing tone and contractibility, and strengthening. One channel with two electrodes may be used. The electrodes are places on the involved muscle. Treatment times generally last between 10 and 15 minutes. Weights may be used and partial ROM exercises may be performed during treatment. Typical contract/relax settings are as follows 10:50, 10:30, 10:10, and continuous. Indications Peripheral nerve injuries Tendon transplants Muscle inhibition Upper motor neuron lesions Disuse atrophy Limited ROM Chronic and acute pain Muscle relaxation 43 Contraindications Pacemakers Directly over metal implants Active bleeding at or near treatment area Malignancies Pregnancy Treatment over the carotid sinus Skin irritation/wound Avoid over anesthetic skin v. Hydrotherapy: Hydrotherapy is any type of treatment modality that uses water. A body part is immersed in water and a turbine motor agitates the water. Typically a hot whirlpool (HWP), warm whirlpool (WWP), and cold whirlpool (CWP) are the preferred options for treatment. Treatment parameters are based on what is the desired outcome and what stage of healing the athlete is in. This is up to the discretion and expertise of each athletic trainer. HWP temperatures range from 99-110 degrees Fahrenheit. WWP temperatures range between 80-99 degrees Fahrenheit. CWP temperatures range between 32-80 degrees Fahrenheit. Indications Sub-acute and chronic inflammation Peripheral vascular disease Peripheral nerve injuries Conditions that produce muscle weakness Contraindications Fever vi. Infections Acute Injury Cardiac instability Hypertension Respiratory instability Malignancies Active bleeding Intermittent Pneumatic Compression: Compression pumps apply external pressure to edematous body parts. Pressure is provided by air that is pumped between two layers via rubber tubing. The compression pump helps to reduce excessive swelling. Treatment times may last up to an hour twice a day until the swelling has subsided. The involved extremity should be elevated 30 degrees during treatment. Stockinet’s should be applied before treatment for sanitation of the air bag attachment and to help retard swelling after treatment is complete. The pressure of the pump should not exceed the athlete's diastolic blood pressure. Girth measurements should be taken before and after treatment. 44 Indications Lymphedema/traumatic edema Venous insufficiency Amputations Contraindications Arterial insufficiency Infections Thrombophlebitis Edema from cardiac dysfunction vii. Quad-7 Cold and Hot compression: The Quad 7 can be used as four different modalities: cold, heat, and compression. The compression component applies external pressure to help reduce excessive swelling. Cold can be used as a vasoconstrictor to limit edema formation and control pain. Heat can be used as a vasodilator prior to practice or competition. The Electrical Stimulation application can be combined with heat or cold therapy through the probe. The probe can be used for focal areas such as trigger points. Indications and Contradications viii. Refer to Cryotherapy, Thermotherapy, Electrical Stimulation, and Compression Iontophoresis: Iontophoresis is a type of direct current that forces medication (typically acetic acid or dexamethasone) through the patch into the target tissue to further help alleviate symptoms. Treatment time lasts between 10 and 40 minutes depending upon the intensity. Treatment may be painful at times and occasionally may burn or blister the epidermis. Medication must be approved by a licensed and practicing physician. The medication is applied to the medicated patch. A dispersive pad must be used. The medicated patch must be placed directly over the affected area. Indications Athletes foot Rhinitis Decubitus ulcers Post-traumatic edema Plantar Warts Trigger points Acute rheumatoid arthritis Acute and subacute inflammation Gout 45 Anesthetic skin Contraindications: Anesthetic skin Recent scars Metal embedded close to the tx area Active bleeding Pacemaker ix. Paraffin: A paraffin bath is one in which a tank is filled with wax and mineral oil mixture. Paraffin is another form of heat therapy used by athletic trainers. It significantly retains perspiration and helps soften the skin. Paraffin treatment may be given daily in sub-acute situations and less often for chronic conditions. Mix the wax and oil according to the directions. Keep mixture in a heated container and recycle it after each use. Athletes must wash hands prior to treatment. The hand or foot may be dipped and removed in the mixture up to ten times or held in the mixture for up to two minutes. After the athlete removes the hand/foot from the mixture they must place it into a plastic bag, and then slip it into a terry cloth cover for up to 15 minutes. Remove dry wax from the involved area after treatment and add it to the original mixture. Indications Sub-acute traumatic and inflammatory conditions Chronic traumatic and inflammatory conditions Contraindications Open wounds Acute injuries Athletes with sensory deficiencies Fever Active bleeding Cardiac insufficiency Persons with unreliable thermoregulatory systems Peripheral vascular disease x. Moist Hot Packs: Moist hot packs are a conductive means of delivering superficial heat. Moist hot packs are made of canvas and filled with silica gel. They are immersed in a heated unit that keeps the temperature at or near 170 degrees Fahrenheit. The heat usually dissipates within a half hour. The pack should be covered with ample padding. As the head dissipates the layers may be removed. Treatment usually takes place before activity and lasts for up to 30 minutes. The canvas of the hot pack must never touch the skin directly. Indications Muscle spasm and/or tightness 46 Sub-acute traumatic and inflammatory conditions Chronic traumatic and inflammatory conditions Contraindications Acute injuries Malignancies Active bleeding Cardiac insufficiency Athletes with unreliable thermoregulatory systems Peripheral vascular disease Athletes with decreased sensations to tx area Edema Mentally confused individual xi. Ultrasound/Phonophoresis: Ultrasound is a heat modality that penetrates the soft tissue up to 5 cm. Ultrasound may be used for a variety of conditions. Specific settings for specific treatment sites and conditions make ultrasound difficult to administer for a layperson. Typically treatment times last between 5-8 minutes. Superficial pathologies are usually treated 2 between 0.1 watts/cm2 and 2.5 watts/cm on a continuous duty cycle. Adjusting the MHz determines the depth of penetration an ultrasound treatment can obtain. Adding a hydrocortisone mixture as a coupling agent to the treatment will increase the inflammation reduction benefit; this is frequently referred to as Phonophoresis. The sound head must be applied to a transmission medium for it to be effective. The sound head must always be in contact with the gel or a water medium so the crystal within the sound head does not shatter. Both circular and stroking patterns (half over half) may be used to deliver the therapy. Indications Soft tissues shortening Joint contractures Scar tissue formations Sub-acute and chronic inflammation Muscle guarding Trigger points Neuromas Contraindications Treatment over the eyes Bleeding in the treatment area Treatment near the uterus during pregnancy Cancer Infection 47 Treatment over the carotid sinus Treatment over the cervical ganglia Pregnancy Over Gonads 48 HEALTH AND SAFETY 49 A. BLOOD-BORN PATHOGENS: The West Liberty University Athletic Training Staff have adopted the OSHA guidelines as the gold standard of care involving situations regarding blood borne pathogens. All athletic training personnel are trained in using Personal Protective Equipment (PPE), and know the potential risks of exposure. In the event of exposure, the involved individual must complete the Exposure Report Form. After the proper documentation is recorded, the athletic trainer will contact the University's Health and Safety Specialist for testing and/or treatment if necessary. PPE must be worn when providing first aid or any other procedure to individuals who may expose the healthcare provider to potentially contaminated bodily fluids (blood, emesis, etc.) After use, protective gloves should be discarded and all other items should be sterilized or laundered. Materials that are contaminated with blood or other bodily fluid including gloves, gauze, towels, etc. should be discarded in an approved red biohazard bag/container. If the contaminated item is a syringe, scalpel or other rigid object it must be discarded in an approved sharps container. Personal Protective Equipment includes: gloves, goggles, face shields, pocket masks, gowns, toe shields, etc. B. MEDICATION DISTRIBUTION: i. Prescription Drug Distribution: Only qualified and board certified physicians (specifically M.D., D.O.) may dispense or administer prescription drugs as needed in an appropriate manner. Standing orders may be issued by the team physician with regard to prescription drug administration. ii. Over the Counter (OTC) Drug Distribution: Anyone of legal age may administer a single dose of OTC medication to an athlete. OTC meds are distributed on an as-needed basis. OTC medications are also available at Health Services and in the Athletic Training Facility. The athlete taking the medication needs to be responsible, both the athletic trainers and the athlete need to be aware of the following information: 1. Medications should only be taken as directed 2. Labels should not be removed from the containers 3. Medications should not be used after the expiration date 4. Oral medications should be taken with a full glass of water unless otherwise directed 5. Containers of medications should be in locked compartments-bottles with childproof lids are preferred 6. Be aware of banned drugs/supplements by NCAA and IOC 7. Provide verbal instructions for medication use 8. Be aware of the dose schedule associated with medication taken 9. Advise athletes not to share medications with others 10. Be aware of interactions of a medication with other drugs, foods, supplements and exercise C. IV THERAPY: IV therapy may be administered when local EMS Advanced Life Support is available, or under physician 50 supervision. See Appendix P. D. TROPICAL ANALGESICS/MEDS: BioFreeze, atomic balm, red hot, hydrocortisone creams, etc. are used to the athletic trainer's discretion in conjunction with current medical standards. E. METERED-DOSED INHALERS: Bronchodilators are available and are used at the discretion ofthe athletic trainer(s) through the regulations for use consistent with the WVEMS. See Appendix P. F. EPIPENS: Epinephrine injectors are available and are used at the discretion ofthe athletic trainer( s) through the regulations for use consistent with the WVEMS. See Appendix P. G. ACETYLSALICYLIC ACID: Aspirin will not be administered by the athletic training staff due to the safety concerns relating to Reye's syndrome. Baby aspirins are on hand in the event of chest pains. Baby aspirins will be administered in a manner consistent with WVEMS. H. DEXAMETHASONE: Iontophoresis using dexamethasone can be done in the athletic training room with a physician’s order. I. SUPPLEMENTS: The West Liberty University Athletic Training Staff does not distribute or endorse any performance enhancing ergogenic aids based on the lack of regulation by the USFDA under the Dietary Supplement Health and Education Act (DSHEA) of 1994. See Appendix Q for a list of NCAA banned substances. J. PREGNANCY: Any athlete with a suspected or confirmed pregnancy will be referred to Health Services or a physician or their choosing for further evaluation, participation guidelines/restrictions, and counseling if necessary. Written medical clearance is required if the athlete wishes to continue athletic participation during pregnancy. Written medical clearance is also required after delivery or termination of a pregnancy. If a student athlete approaches an athletic trainer about a suspected or confirmed pregnancy, all information will be kept confidential. K. HEAT ILLNESS: During athletic events the athletic training staff carefully monitors the temperature and humidity using the National Weather Service and sling/digital psychrometer measurements. Athletes are constantly reminded to maintain their hydration status, especially sports that require protective equipment. Coaches are also made 51 aware of any potential health risks due to the temperature and humidity. Practice and competition modifications are suggested by the athletic training staff, and Gatorade and ice towels are provided on an as needed basis. L. LIGHTNING SAFETY POLICY: The NCAA lightning policy recommends that someone is specifically designated to monitor the weather conditions at all events and practices and they adhere to the NCAA’s standard of safety regarding weather. Certified Athletic Trainers are by the very nature of their job responsible for the well-being and safety of the athletes that they work with without regard to wins, losses, or quality/quantity of practice. Certified Athletic Trainers are taught weather management skills didactically and clinically because of its literal translation to protecting athletes. It is for this reason that West Liberty University recommends that a Certified Athletic Trainer have the unchallengeable authority to postpone any practice or contest due to the threat of lightning and that the Certified Athletic Trainer has the unchallengeable authority over return to play decisions. i. West Liberty University Lightning Policy 52 53 54 M. INFECTION CONTROL AND PREVENTION The following infection control information sheets are posted throughout the athletic event and locker areas. 55 56 EMERGENCY PROCEDURES 57 A. EMERGENCY ACTION PLANS: NATA guidelines state that it is necessary to create an Emergency Action Plan for each facility that is used by the athletic population. The purpose of an emergency action plan is to provide easy, accurate, and concise directions in the event of a medical emergency. West Liberty University Athletic Training abides by this guideline and has posted specific Emergency Action Plans for each athletic venue. A. ASRC Athletic Weight Room B. ASRC Basketball Court C. ASRC Men's Visiting Locker Room D. ASRC Women's Visiting Locker Room E. ASRC Indoor Track F. Baseball Field G. Blatnik Gym H. Blatnik Locker Room I. Blatnik Swimming Pool J. H. Edgar Martin Tennis Complex K. Soccer/Baseball Athletic Training Room L. Soccer Complex M. Softball Field N. West Family Stadium Game day O. West Family Stadium General P. Wrestling Practice Room 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 OTHER POLICIES AND PROCEDURES 75 A. PORTABLE RADIO USAGE GUIDELINES: The use of portable radios in athletic training is for professional communication only. In order to assure clear communication between the staff, plain talk should be used on the staff radio. The use of codes, signals, slang, etc. is discouraged. West Liberty University Athletic Training utilizes two different types of portable radios. The first type is Motorola brand commercial/consumer portable radios. Currently, the athletic training staff has six of these radios on hand with certain accessories. These are used to communicate within the staff only. These radios should be set on channel 15, security code 1. The second type of portable radio used by the staff is West Liberty Volunteer Fire Department portable radios. These radios offer direct access to Ohio County EMS, Brooke County EMS, Ohio County Law Enforcement, Wheeling Hospital, and OVMC. There are currently two of these radios on hand. These radios are to be used by the FD members only. As this system is part of the county-wide system, certain codes may be used. (See Below). Non-essential communication on these radios is strictly prohibited. Ohio County EMS radio: Herb Minch: West Liberty Fire Station West Liberty Chief West Liberty Assistant Chief West Liberty Captain West Liberty Lieutenants West Liberty Ambulance West Liberty Support Clearview VFD Ambulance Bethany VFD Ambulance WLU Campus Police West Liberty Police Ohio County Sheriff’s Dept WV State Police West Liberty Unit #4 40 41 42 43,44 44-1 through 44-4 45 or 45-1 48-1 85 25 or 25-1 1400 1300 Units 1-36 140, 309, 456, 648 Ohio County EMS radio 76 Athletic Training Program Student Handbook This handbook outlines the rules and regulations that you as a student in the Athletic Training Program at West Liberty University must follow. As an Athletic Training Student (ATS), you are responsible for abiding by these rules and regulations as well as other rules established by the university. Every attempt will be made to adhere to these rules consistently. In extenuating circumstances, the program director and/or clinical education coordinator reserve the right to make decisions on an individual basis. 77 A Note to You as an Athletic Training Student: After reading and signing the Student Policies Agreement form at the end of the document, you will have agreed to abide by the Code of Ethics (Appendix A) that governs the behavior of those working in this profession. This is a serious responsibility that you assume as a student in this program. While the contents of this handbook give you specific information about your conduct and behavior as a student, you should always remember that the Code of Ethics is your guide while you are preparing to become an athletic training professional. (See section on Athletic Training Code of Ethics) Good Luck and we are pleased to have you in the Athletic Training Program. Dr. Hanna 78 STUDENT HANDBOOK TABLE OF CONTENTS A. WLU Athletic Training Program Mission Statement ................................................. 81 B. WLU Athletic Training Program Outcomes .............................................................. 81 C. Progression in Program............................................................................................... 81 1. GRADE-POINT REQUIREMENTS ...............................................................................................81 2. STUDENT PRE-CLINICAL PHYSICALS ......................................................................................81 3. CLINICAL ROTATIONS .............................................................................................................82 4. D. E. a. AT 200 Athletic Training Clinical Practicum I – 1 hour ...........................................82 b. AT 205 Athletic Training Clinical Practicum II– 1 hour...........................................82 c. AT 300: Athletic Training Clinical Practicum III – 2 hours ......................................82 d. AT 305: Athletic Training Clinical Practicum IV – 2 hours .....................................83 e. AT 400: Athletic Training Clinical Practicum V – 2 hours .......................................83 f. AT 405: Athletic Training Clinical Practicum VI – 2 hours .....................................83 CLINICAL HOURS POLICY .......................................................................................................84 Attendance Policy ....................................................................................................... 84 1. CLASS ATTENDANCE ..............................................................................................................84 2. CLINICAL ATTENDANCE..........................................................................................................84 a. Excused Absences ......................................................................................................84 b. Unexcused Absences .................................................................................................85 c. Calling off during your clinical rotation ....................................................................86 d. Clinical Tardiness ......................................................................................................86 e. Expected Hours of Work ...........................................................................................86 f. Make-up Time ............................................................................................................86 g. Illness during Clinical Attendance .............................................................................87 h. Injury during Clinical Attendance .............................................................................87 i. Extended Illness/Injury Policy ...................................................................................87 j. Inclement Weather Policy ..........................................................................................88 Composite Clinical Performance Evaluation ............................................................. 88 1. GRADING ................................................................................................................................88 a. Student Notebooks .....................................................................................................88 b. Clinical Academic Assignments ................................................................................89 c. Final Evaluation Forms ..............................................................................................89 79 d. F. Clinical Rotation Rules and Guidelines...................................................................... 91 1. APPEARANCE/DRESS CODE.....................................................................................................91 2. SPECIFIC RULES AND REGULATIONS .......................................................................................93 3. IMPAIRED THINKING ...............................................................................................................93 a. G. H. I. Cheating and Plagiarism ............................................................................................89 Drug/Alcohol Use ......................................................................................................93 4. CRIMINAL BACKGROUND CHECK............................................................................................94 5. PREGNANCY POLICY ...............................................................................................................94 6. INFECTIOUS DISEASE POLICY ..................................................................................................94 7. HIPAA TRAINING ...................................................................................................................94 8. UNIVERSAL PRECAUTIONS ......................................................................................................94 9. CPR CERTIFICATION ...............................................................................................................96 10. HEALTH INSURANCE ...............................................................................................................96 Additional Costs ......................................................................................................... 96 1. MALPRACTICE INSURANCE .....................................................................................................96 2. STUDENT TRANSPORTATION ...................................................................................................96 3. STUDENT HOUSING .................................................................................................................96 General Information/Activities ................................................................................... 96 1. STUDENT EMPLOYMENT .........................................................................................................97 2. ATHLETIC PARTICIPATION ......................................................................................................97 3. ATHLETIC SEASON ..................................................................................................................97 4. STUDENT HEALTH REPORTING POLICY ...................................................................................97 5. PROFESSIONAL ASSOCIATION MEMBERSHIP ...........................................................................97 Disciplinary Procedures .............................................................................................. 98 1. FIRST OFFENSE: ......................................................................................................................98 2. SECOND OFFENSE: ..................................................................................................................98 3. THIRD OFFENSE: .....................................................................................................................98 a. Permanent Dismissal from a Clinical Site .................................................................98 J. NATA Code of Ethics ................................................................................................ 100 K. STUDENT POLICIES AGREEMENT ...................................................................... 102 80 A. WLU Athletic Training Program Mission Statement The Mission of the WLU ATP is to graduate a student that demonstrates effective communication and ethical decision making while always considering patient-centered values. In addition, the ability to practice and apply evidence-based medicine in patient care is vital. As well as providing a culture of peer mentoring and leadership that builds knowledge, strengthens clinical skill application, and facilitates an environment of continuous learning, while constantly advocating for the profession of athletic training in various health care settings. B. WLU Athletic Training Program Outcomes Objective #1: Students will demonstrate the ability to provide quality healthcare to a diverse patient population in various healthcare settings. Objective #2: Students will understand the roles and responsibility of an Athletic Trainer across a variety of health care settings. Objective #3: Students will develop the knowledge and skills necessary to interpret current evidence-based research and apply it to clinical practice. Objective #4: Students will be able to communicate effectively to a variety people in various health care professions. C. Progression in Program 1. Grade-Point Requirements Successful completion of all required courses is necessary for you as a student in the Athletic Training major to progress in the program. You are expected to meet and maintain at least a 2.8 overall University GPA for all Core courses. You must also earn at least a C or better in ALL athletic training program courses, as well as in other specified courses from the athletic training program. Violations of this policy will be dealt with on a case-by-case basis by the program director. 2. Student Pre-Clinical Physicals All accepted athletic training program students are required to have submitted a completed “Mandatory Health form” and updated immunization records to the University Health Center prior to the return of the sophomore year. Failure to do so will delay the students’ participation in their clinical rotations. Further proof of health records or additional requirements might be expected for off-campus clinical rotations. This is dependent upon and individualized to each site, and students will be expected to comply. 81 3. Clinical Rotations (Six Clinical Practicums over six semesters described below) All students are required to be familiar with the Emergency Action Plan at each site as well as the NCAA Sports Medicine Handbook if indicated. a. AT 200 Athletic Training Clinical Practicum I – 1 hour This clinical rotation allows for the sophomore level student to gain experience in the profession of Athletic Training outside of the classroom and in the clinical setting. Under the supervision of a preceptor, the student will be challenged to transfer knowledge learned didactically and apply it in the clinical setting. Students will be expected to begin to understand and demonstrate the knowledge and skills identified in the Standards as designated by the CAATE (Commission on Accreditation of Athletic Training Education) and its eight content areas: Evidence-Based Practice; Prevention and Health Promotion; Clinical Examination and Diagnosis; Acute Care of Injury and Illness; Therapeutic Interventions; Psychosocial Strategies and Referral; Healthcare Administration; and Professional Development and Responsibility. A minimum of 75 clinical hours is required to earn credit for the class. Prerequisites: AT 100: minimum grade “B”, AT 115: minimum grade “C.” b. AT 205 Athletic Training Clinical Practicum II– 1 hour This clinical rotation allows for the sophomore level student to gain experience in the profession of Athletic Training outside of the classroom and in the clinical setting. Under the supervision of a preceptor, the student will be challenged to transfer knowledge learned didactically and apply it in the clinical setting as well as build on current information learned in the first clinical practicum. Students will be expected to begin to understand and demonstrate the knowledge and skills identified in the Standards as designated by the CAATE (Commission on Accreditation of Athletic Training Education) and its eight content areas: Evidence-Based Practice; Prevention and Health Promotion; Clinical Examination and Diagnosis; Acute Care of Injury and Illness; Therapeutic Interventions; Psychosocial Strategies and Referral; Healthcare Administration; and Professional Development and Responsibility. A minimum of 75 clinical hours is required to earn credit for the class. Prerequisites: AT 200: minimum grade “C.” c. AT 300: Athletic Training Clinical Practicum III – 2 hours Building on the first year of clinical experiences, students will continue to be challenged to transfer knowledge gained in the classroom and apply it in the clinical settings. Under the supervision of a preceptor, the students will be expected to demonstrate the knowledge and skills identified in the Standards as designated by the CAATE (Commission on Accreditation of Athletic Training Education) and its eight content areas: Evidence-Based Practice; Prevention and Health Promotion; Clinical Examination and Diagnosis; Acute Care of Injury and Illness; Therapeutic Interventions; Psychosocial Strategies and Referral; Healthcare Administration; and Professional Development and Responsibility. A minimum of 150 clinical hours is required to earn credit for the class. Prerequisites: AT 205: minimum grade “C.” 82 d. AT 305: Athletic Training Clinical Practicum IV – 2 hours Building on the first year of clinical experiences, students will continue to be challenged to transfer knowledge gained in the classroom and apply it in the clinical settings. Under the supervision of a preceptor, the students will be expected to demonstrate the knowledge and skills identified in the Standards as designated by the CAATE (Commission on Accreditation of Athletic Training Education) and its eight content areas: Evidence-Based Practice; Prevention and Health Promotion; Clinical Examination and Diagnosis; Acute Care of Injury and Illness; Therapeutic Interventions; Psychosocial Strategies and Referral; Healthcare Administration; and Professional Development and Responsibility. A minimum of 150 clinical hours is required to earn credit for the class. Prerequisites: AT 300: minimum grade “C.” e. AT 400: Athletic Training Clinical Practicum V – 2 hours Senior level students will now have four semesters of clinical practicum cohort entering their final year of the program. The students will continue to be challenged to transfer knowledge gained in the classroom and apply it in the clinical settings. Under the supervision of a preceptor, the students will be expected to demonstrate the knowledge and skills identified in the Standards as designated by the CAATE (Commission on Accreditation of Athletic Training Education) and its eight content areas: Evidence-Based Practice; Prevention and Health Promotion; Clinical Examination and Diagnosis; Acute Care of Injury and Illness; Therapeutic Interventions; Psychosocial Strategies and Referral; Healthcare Administration; and Professional Development and Responsibility. At the senior level it is to be expected the student will be polishing the skills of a successful clinician such as evaluation skills, critical thinking and problem solving, exercise and rehabilitation prescriptions and appropriate decision making when diagnosing injuries and choosing modalities for treatment plans. A minimum of 150 clinical hours is required to earn credit for the class. Prerequisites: AT 305: minimum grade “C.” f. AT 405: Athletic Training Clinical Practicum VI – 2 hours Senior level students will now have four semesters of clinical practicum cohort entering their final year of the program. The students will continue to be challenged to transfer knowledge gained in the classroom and apply it in the clinical settings. Under the supervision of a preceptor, the students will be expected to demonstrate the knowledge and skills identified in the Standards as designated by the CAATE (Commission on Accreditation of Athletic Training Education) and its eight content areas: Evidence-Based Practice; Prevention and Health Promotion; Clinical Examination and Diagnosis; Acute Care of Injury and Illness; Therapeutic Interventions; Psychosocial Strategies and Referral; Healthcare Administration; and Professional Development and Responsibility. At the senior level it is to be expected the student will be polishing the skills of a successful clinician such as evaluation skills, critical thinking and problem solving, exercise and rehabilitation prescriptions and appropriate decision making when diagnosing injuries and choosing modalities for treatment plans. A minimum of 150 clinical hours is required to earn credit for the class. Prerequisites: AT 400: minimum grade “C.” 83 4. Clinical Hours Policy All students are to meet the minimum requirements for clinical hours based on their current level of clinical practicum class for which they are enrolled. All 200 level classes require completion of a minimum of 75 clinical hours and all 300 and 400 level classes require completion of a minimum of 150 hours. However, students most likely exceed these minimums and should expect this to occur. These hours are inclusive to actual hours of work and not travel or hotel time on trips. A student’s maximum hours of clinical work should not include more than 20 hours a week in any Practicum or 300 hours per semester or 600 per year. D. Attendance Policy 1. Class Attendance You are expected to attend all class meetings. Attendance is checked at the discretion of each professor. Specific attendance requirements are delineated in each course syllabus. It is your responsibility to obtain assignments and materials missed during any absence. 2. Clinical Attendance You are prohibited by the CAATE standard #59 to receive any compensation whatsoever for your clinical education experiences and work related to that of your clinical education experiences. You are required to attend all clinical experiences per the specific site’s schedule. It is to be treated like a work schedule for a real, paying job. You are expected to make these schedules with your Clincial Preceptor and adhere to them during the semester. Failure to do so could result in a change in your grade and possibly removal from the program. If you have another job, it is your responsibility to arrange your clinical site hours with your preceptor. It is your responsibility to keep accurate and updated time sheets or a spreadsheet of actual times worked at each clinical rotation. Time sheets or the spreadsheet can each be obtained from the clinical coordinator. Tardiness and leaving early must be documented with the reason why and the clinical supervisor’s signature. Time sheets will be inspected at the clinical coordinator’s visit. Failure to complete these time sheets properly and accurately will result in no credit for those clinical hours in question, and you must make up those hours. Any discrepancy in time recorded on the time sheet and the time you actually worked could result in an UNEXCUSED absence and will be handled on an individual basis with the clinic education coordinator. a. Excused Absences In each clinical rotation you are permitted a total of three excused absences that you do not need to make up. You will be granted an excused absence for the following reasons: 84 1. Other WLU activities that could be academic in other classes or extracurricularrelated such as athletics, theater, etc. You must provide a note from the corresponding professor for a valid excuse to miss. 2. A death in the immediate family. 3. Injury or illness. Should you be absent longer than two consecutive days because of injury or illness, you will be required to obtain a physician’s excuse stating the date of the physician’s visit and the specific recommendation that you should not attend clinical rotation for a given number of days. Additionally, the program director reserves the right to require a physician’s excuse for any questionable absence. b. Unexcused Absences The following are considered UNEXCUSED absences and will count toward your three available to miss during the semester: 1. Any absence for reasons other than those stated above. 2. Absence because of injury or illness greater than two consecutive days without a physician’s excuse. 3. Failure to follow the call-off policy. (See Call-Off Policy) 4. Any tardiness that exceeds the limit of three per clinical rotation. (See Clinical Tardiness Policy) 5. Failure to call the clinical supervisor at the site when you will be more than 30 minutes late for work. (See Clinical Tardiness Policy) 6. Leaving early without prior approval from the clinical supervisor at the site. 7. Any discrepancy between time recorded on the time sheet and time actually worked. 8. Any dismissal by the clinical supervisor at the site because of inappropriate and unacceptable behavior. Time missed because of an unexcused absence must always be made up. Any quizzes or tests missed will be receive the grade of “0” (See Make-Up Time Policy). * The program director and/or the clinical coordinator may deal with any unexcused absence at his/her discretion. Most incidences will follow the Disciplinary Policy of the WLU Handbook and will be handled according to the disciplinary policy. (See Disciplinary Procedure.). 85 c. Calling off during your clinical rotation 1. If you should be absent from a clinical rotation for any reason, please try to notify your preceptor at least an hour ahead of scheduled starting time. *Failure to follow this procedure exactly will result in an UNEXCUSED absence. d. Clinical Tardiness Tardiness is defined as arriving at the clinical area any time later than the scheduled starting time, regardless of the reason. If you realize that you will be more than 30 minutes late to work, you must notify your preceptor immediately. If he/she is not available, a message should be left with the clinical site. Tardiness is neither tolerated nor professional; however, you are permitted two incidents of tardiness before receiving an UNEXCUSED absence, providing that the above notification procedure was followed. Failure to follow this procedure will result in an UNEXCUSED absence. Any UNEXCUSED absence will be handled according to the disciplinary policy (See Disciplinary Procedure.). The reason for any tardiness must be documented on your time sheet and signed by your preceptor. The time missed must also be made up. Arrangements will be made between you and the preceptor. (See Make-up Time) e. Expected Hours of Work You are prohibited by the CAATE standard #59 to receive any compensation whatsoever for your clinical education experiences and work related to that of your clinical education experiences. Work times are dependent upon your site location, the athletic team to which you have been assigned, and your preceptor. Many times, your schedule will be determined by the starting and ending times of athletic practices and events. The preceptor at each site will determine starting and finishing times. Be prepared for sudden changes in work schedules as practices and games might be changed because of weather or the head coach’s needs. THIS IS YOUR EDUCATION AND CLINICAL PRACTICUM ROTATION. IT IS TO BE TREATED AS SUCH. You are required by the CAATE standard #58 to have at least one day off in a seven day period. This will be addressed by your preceptor at your clinical site rotation, while individual schedules are being constructed. f. Make-up Time Any unexcused absence from a clinical rotation must be made up. It is your responsibility to schedule this make-up time with both the clinical coordinator and the preceptor at the site. Any assignment 86 missed as a result of any absence must also be completed. A grade of “0” will be given for any quiz or test missed because of an unexcused absence. Failure to make up the missed hours in a timely fashion will be handled according to the disciplinary policy (See Disciplinary Procedures). g. Illness during Clinical Attendance If you become ill during clinical practice, you should notify your preceptor and proceed as directed by the clinical supervisor. If the preceptor permits you to leave because of illness, it will be considered an excused absence, and the hours must be made up if you have exceeded three excused absences. If you leave the clinical site, the clinical coordinator should be notified that day. (See Excused Absences Policy) h. Injury during Clinical Attendance If you are injured in any way during a clinical experience, you must report the injury to the preceptor and to the clinical coordinator at WLU. You must then follow the procedure required by the clinical site. If such procedures involve emergency room services or other treatment, you will be responsible for any expenses incurred. (See Health Insurance Explanation) i. Extended Illness/Injury Policy The following duties listed below are necessary for the completion of each clinical rotation. On a daily basis, any or all of these might be required. The full spectrum of duties necessary in the practice of athletic training may include more, but these are some of the more common ones: 1. Moving and lifting patients/athletes 2. Moving and lifting water coolers and ice chests 3. Pushing and pulling wheelchairs 4. Obtaining histories from patients 5. Stocking the training room shelves with equipment and supplies 6. Loading and unloading medical and travel supplies on trips. You will not be able to participate in a clinical rotation unless you can perform the aforementioned tasks. Should an extended illness/injury occur that prevents you from performing at full capacity as listed above, the following procdures must be followed: 1. Notify the clinical coordinator and preceptor of your site as soon as possible. 2. Written documentation from your physician including the time expected to be absent from the clinical rotation clinical must be faxed to the clinical coordinator as soon as possible and no later than five days after work has begun being missed. 87 3. Missed time is expected to be made up after you obtain a physician’s release stating that you are able to perform all duties with no limitations. 4. You may not return to the clinical setting without the prior approval of the clinical coordinator or program director. Should the illness or injury require you to be absent from the clinical rotation longer than one month, your situation must be reevaluated before you may re-enter the rotation. Re-entry depends on your clinical/academic performance prior to the illness or injury. If your clinical/academic performance was less than satisfactory, you may not be able to re-enter the program. Re-entry will be the decision of the program director/clinical coordinator and the academic administration at the institution and will be evaluated on an individual case basis. You must make up any time missed because of extended illness or injury. It is your responsibility to make these arrangements with the clinical coordinator. Failure to make up the missed time could result in dismissal from the program. j. Inclement Weather Policy When inclement weather causes driving conditions to be hazardous, attendance at clinical rotation is left to your discretion. You should call the preceptor at the site to discuss road conditions. Missed time will need to be made up when missed. E. Composite Clinical Performance Evaluation This section entails the entire clinical practicum experience. If any aspect of the following subsections is deemed to be incomplete or inadequate by the clinical coordinator, the situation will be handled individualy. Other appropriate university personnel could become involved as necessary. 1. Grading Each clinical site could have the following items graded regularly throughout the semester: 1. Student notebooks, any written or oral projects, assignments, or quizzes (assigned at that particular site, which is that site coordinator’s discretion) 2. Final evaluation and grade from clinical site 3. Performance Skill Objectives a. Student Notebooks Each student will be responsible for keeping a log of his/her clinical- rotation experiences. It will be at the discretion of the clinical coordinator as to what information needs to be included during each expericence. This will be provided to you based upon your rotation year in the program. You will be given a format to follow prior to starting your clinical rotation. 88 b. Clinical Academic Assignments You are responsible for the completion of any projects, assignments, quizzes, or tests that may be given to you during a clinical rotation. The clinical coordinator or the preceptor at the site may make assignments. You will be given advance notice of any quiz or test. Any missed assignment must be completed, but any quiz or test missed because of an unexcused absence will receive a grade of “0.” c. Final Evaluation Forms A final evaluation form will be completed at the end of your clinical experience at each site. These forms are located on ATrack. You and the preceptor for your clinical site whill complete these. d. Cheating and Plagiarism Neither cheating nor plagiarism will be tolerated—at all!!!! West Liberty University Academic Standards are to be upheld at all times. The faculty has the responsibility for seeing that all students receive credit for work they have done. Should cheating or plagiarism be suspected, it will be dealt with per university policy and procedure. Students are also expected to report any observed instances of dishonesty to the instructor in charge. Failure to do so makes the observer as guilty as the one who is cheating. Students will not receive credit for work which is not their own. If proven, cheating could result in expulsion from the program and the university in accordance with the university policy and procedures. Each incident will be handled on an individual basis. Plagiarism is the use of another’s words, writings, thoughts, or ideas without giving proper credit. Taking a section of a book or a magazine article and copying it essentially word for word without giving proper credit to the author is one example of plagiarism. The instructor who detects plagiarism will review with you the circumstances that constitute plagiarism. If proven, plagiarism could result in expulsion from the program and the university in accordance the university policy and procedures. Each incident will be handled on an individual basis. 89 90 F. Clinical Rotation Rules and Guidelines 1. Appearance/Dress Code As a student, you represent both West Liberty University and the profession of Athletic Training. You are expected to dress and conduct yourself in a professional, responsible manner. Your clothing is to be appropriate and in accordance with whatever site you are assigned. You must wear appropriate clothing at all times or face reprimand from the necessary parties involved. *You may be expected to purchase clothing for your clinical site depending on the site. Students are highly encouraged to raise funds as an AT club for items such as these. *You must be wearing approved apparel for your clinical sites, especially game coverages per your site. West Liberty University Clinical Athletic Training Program Dress Code As an athletic training student, you represent both West Liberty University and the profession of Athletic Training during your clinical rotations. You are expected to dress and conduct yourself in a professional, responsible manner. Your clothing is to be appropriate and in accordance with professional standards. You must wear appropriate clothing at all times. Site‐specific shirt/T‐shirt/polo (cannot have another school’s name/logo). No skirts or dresses for day-to-day operations. No low-cut fitting shirts or tank tops Shirts should be tucked in, and belts are highly recommended. Khaki or athletic type shorts/pants. Shorts cannot be shorter than mid-thigh. No jeans. Shoes worn should be safe and comfortable. Sandals, flip-flops, clogs, slippers, open-toed shoes, or heels are not permitted for day-to-day operations. Socks must be worn at all times. Open-toed shoes and heels are permitted when worn as part of a formal outfit. 6. No holes in any clothing. 7. Hair must be neat and clean. Hair must not come in contact with the patient. Beards, moustaches and sideburns must be neat and trimmed. 8. Jewelry should not be excessive. Earrings, rings, and necklaces should be kept to a minimum. Only small earrings may be worn. No visible piercings beyond the ears. 9. Tongue and nose piercings are to be removed during your rotations. 10. Cosmetics must convey a professional appearance. Make-up should not be excessive. The length of the fingernails must promote patient and employee safety. Nail polish must be appropriate and in good repair. 11. No hats are to be worn during inside-event coverage. 12. If you are working with a sport that has specific dress requirements, you must adhere to the team’s dress code. 1. 2. 3. 4. 5. 91 The dress code at each clinical site may vary; however, the WLU athletic training program dress code is the minimum expectation. If a clinical site allows for attire that violates the WLU athletic training program dress code, students are expected to follow our stringent guidelines. If a clinical site requires attire that goes beyond the WLU athletic training program minimum requirements, the student must follow the sites dress code. Dress Code Violations: If you arrive at a clinical site inappropriately dressed, the Preceptor at the site reserves the right to send you home to change into the appropriate attire. You will be required to make up the time. Further violations will result in more severe penalties, which will be handled by the clinical education coordinator. Should you arrive at a clinical site inappropriately dressed, the preceptor may send you home to change into appropriate attire. You will be required to make up any missed time. Failure to abide by dresscode policy could result in decreased a grade, loss of academic progress, or other measures deemed necessary. 92 2. Specific Rules and Regulations You are required to abide by the specific rules and regulations set forth by the clinical site to which you are assigned. Other WLU athletic training program regulations include: 1. Outside Telephone Calls: You are permitted to use phones only with prior permission. You may make outside local calls or telephone your adviser or clinical coordinator for related clinical or university business; however, any personal calls must be approved prior to making them. Social calls and texting are prohibited. It is prohibited to be on the sidelines of an event making any type of call other than summoning the EMS or patient-related aid. If you need to make a call that can’t wait, obtain permission to leave the sidelines or court. Do not make calls or be on cell phone while covering events or practices. It is extremely unprofessional and WILL affect your grade. 2. Follow your clinical schedule regarding vacation and days for holidays as determined by the clinical coordinator prior to the beginning of the clinical rotation. You will not follow the West Liberty University school calendar during clinical rotations. And you will be expected to be at the university for coverage of you team should it run into breaks and holidays. 3. You are to present yourself in a professional manner at all times and abide by the previously set rules and regulations of your assigned clinical site. Failure to do so can result in dismissal from the program. 4. There is to be absolutely no trash talking or engagement in conversation with opposing team players, coaches, staff or officials other than medically related topics. 3. Impaired Thinking Impaired thinking constitutes a risk to patient safety. Impaired thinking is evidenced by an inability to make appropriate judgments and carry out athletic training tasks in relation to situations that arise. Impaired thinking may be the result of fatigue, anxiety, sleep deprivation, medication use, illegal drug use, alcohol use, etc. A preceptor who determines that you are exhibiting evidence of impaired thinking can ask you to leave the clinical area and consult with the program director. You will be given an unexcused clinical absence. (See Unexcused Absences). If drug or alcohol use is responsible for the impaired thinking, you will be permanently dismissed from the program. a. Drug/Alcohol Use 1. Drug and Alcohol Use at Affiliated Clinical Sites is Prohibited a. If you are at a clinical site under the influence of drugs or alcohol or use drugs or alcohol, you will be immediately and permanently dismissed from the Athletic Training Program and will suffer any other university consequences regarding this behavior. 93 4. Criminal Background Check Background checks may be required for West Liberty University Athletic Training Students based upon your clinical assignment for that semester. If the background check reveals a conviction or other information relevant to the position, you may be disqualified from holding that position. Your background report may contain the following information: Criminal records (fingerprints) Civil records Social Security verification Credit reports Employment history 5. Pregnancy Policy Should you discover that you are pregnant during a clinical rotation, it is recommended you notify the program director as soon as possible so necessary arrangements can be made—mainly for the appropriate health of the child. Should the pregnancy interfere with your ability to complete your rotation at that site, all efforts will be made to accommodate you, but no guarantees can be made. 6. Infectious Disease Policy Students understand they must not attend their clinical rotation at anytime should they acquire any contagious personal illnesses or infectious diseases of any kind. Furthermore, students are to follow communication and clinical attendance policies with their clinical preceptor as detailed in the call off proceedures. Because of the nature of the healthcare profession, students participating in required clinical education experiences will find themselves at risk for exposure to infectious diseases. Because you interact with many athletes (or patients), you could inadvertently transmit disease organisms from one person to another. Therefore, following the Standard Precautions (transmission-based precautions) set in place to reduce the transmission of disease organisms is required. This may require the use of gloves, gowns, and/or masks depending upon the type of transmission and the setting in which you are assigned. Trainings are on an annual basis within the athletic training program and completions of these trainings by the students are kept on file with the clinical coordinator. 7. HIPAA Training This HIPAA training will be offered annually at WLU and must be completed each year prior to your beginning a clinical rotation or observation hours. Because this training is mandatory, your completion of it is documented and kept on file by the Program Director at West Liberty University. Failure to complete this training will prohibit you from attending your clinical site until the training is complete, and it could affect your clinical practicum grade. 8. Universal Precautions This BBP training will be offered annually at WLU and must be completed each year prior to your beginning a clinical rotation or observation hours. Because this training is mandatory, your completion 94 of it is documented and kept on file by the Program Director at West Liberty University. Failure to complete this training will prohibit you from attending your clinical site until the training is complete, and it could affect your clinical practicum grade. Because medical history and examination cannot reliably identify all patients infected with HIV and other blood-borne pathogens, blood and body fluid precautions should be consistently used for all patients. This approach, previously recommended by CDC and referred to as “universal blood and body fluid precautions” or “universal precautions,” should be used in the care of all patients, especially including those in emergency-care settings in which the risk of blood exposure is increased and the infection status of the patient is usually unknown. In any case, you are required to wear gloves, change them as necessary, and wash your hands after every patient to reduce the chances of transmitting an infectious organism. There are no exceptions to this requirement. 1. All healthcare workers should routinely use appropriate barrier precautions to prevent skin and mucous-membrane exposure when contact with blood or other body fluids of any patient is anticipated. Gloves should be worn for touching blood and body fluids, mucous membranes, or non-intact skin of all patients and for handling items or surfaces soiled with blood or body fluids. Gloves should be changed after contact with each patient. 2. Hands and other skin surfaces should be washed immediately and thoroughly if contaminated with blood or other body fluids. Hands should be washed immediately after gloves are removed. 3. All healthcare workers should take precautions to prevent injuries caused by needles, scalpels, and other sharp instruments or devices during procedures, when cleaning used instruments, during disposal of used needles, and when handling sharp instruments after procedures. Athletic training students should seldom if ever come in contact with any of these. However, if the situation arises, to prevent needle-stick injuries, needles should not be recapped, purposely bent or broken by hand, removed from disposable syringes, or otherwise manipulated by hand. After they are used, disposable syringes and needles, scalpel blades, and other sharp items should be placed in puncture-resistant containers for disposal; the puncture-resistant containers should be located as close as practical to the use area. 4. Although saliva has not been implicated in HIV transmission, to minimize the need for emergency mouth-to-mouth resuscitation, mouthpieces, resuscitation bags, or other ventilation devices should be available for use in areas in which the need for resuscitation is possible. 5. Healthcare workers who have exudative lesions or weeping dermatitis should refrain from all direct patient care and from handling patientcare equipment until the condition resolves. 6. Pregnant healthcare workers are not known to be at greater risk of contracting HIV infection than healthcare workers who are not pregnant; however, if a healthcare worker develops HIV infection during pregnancy, the infant is at risk of infection resulting from perinatal transmission. Because of this risk, pregnant healthcare workers should be especially familiar with and strictly adhere to precautions to minimize the risk of HIV transmission. 7. Implementation of universal blood and body-fluid precautions for ALL patients eliminates the need for use of the isolation category of “Blood and Body Fluid Precautions” previously recommended by the CDC for patients known or suspected to be infected with blood-borne pathogens. Isolation, precautions (e. g. , enteric, “AFB”) should be used as necessary if associated conditions, such as infectious diarrhea or tuberculosis, are diagnosed or suspected. 95 **Taken from (with some changes): Recommendation for Prevention of HIV Transmission in Health Care Settings, U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control, Atlanta, Georgia 30333. 9. CPR Certification All students participating in a clinical rotation must have current CPR certification. A copy of the current CPR certification card will be kept in the student file, and the original should be with the student at each clinical site. Trainings and classes to provide this certification are offered at WLU. 10. Health Insurance Health insurance is a requirement for all clinical rotations. If you do not own insurance or are not covered, you must make arrangement with the clinical coordinator to obtain some form of coverage. G. Additional Costs 1. Malpractice Insurance All athletic training program students are required to carry student professional malpractice insurance through West Liberty University. The university has arranged for a blanket coverage policy. A copy of this will be with the program director. 2. Student Transportation You are responsible for your transportation to and from the university and all clinical facilities. Student car pools are the responsibility of the individual student and not the responsibility of the university. Arrangements for transportation should be made prior to entering the program. You WILL be driving to off-campus clinical sites for some rotations. 3. Student Housing Arrangements for housing will be made by the clinical education coordinator and the university prior to the school year commencing or during any sort of break to allow you to be on campus with athletic teams during non-academic times. This is expected as part of your clinical experience and your athletic training program educaiton. H. General Information/Activities 96 1. Student Employment Employment during the course of study is the choice of the student and mandates good timemanagement skills. You will not be discouraged from employment, but you will also not be excused from clinical rotations for work-related issues. You are a student first and foremost, and your clinical rotation is your education, and requirements should be scheduled around work—not the other way around. It is up to you to have good communication with your employer and your preceptor about potential conflicts. These conficts will be dealt with individually by the clinical education coordinator. 2. Athletic Participation The WLU athletic training program wants to try to provide you with the best collegiate experience possible. The athletic training program program will not prohibit you from participating on an athletic team, although it will require some extra planning and commitment if you choose to do so. The athletic training program will do everything it can to schedule clinical times appropriately. It should be noted that academics come first, especially in the off-season. But the athletic training program would never ask you to miss an in-season game or practice to work clinical hours. This scheduling will be dealt with by the clinical education coordinator on a sport-specific and clinical site-specific basis. 3. Athletic Season Your education comes before athletics. You can expect to have some conflicts if you choose to do both. Arrangements will be made to lessen your load during in-season sports. The clinical education coordinator will try to be as flexible as possible with everyone, but there are no guarantees. Conflicts need to be communicated to the clinical coordinator immediately to eliminate any confusion. You will probably miss some practices and games as a result of your off-season schedule with athletics and your clinical requirements. The key is good communication among you, the coach, and the clinical coordinator. 4. Student Health Reporting Policy You must notify the program pirector at West Liberty University and the preceptor at the clinical site of any and all contracted diseases or health problems that might or could jeopardize an athlete’s and/or coworker’s health at each clinical site. If you are involved with a blood and/or body fluid exposure, you must have follow-up testing at your personal physician’s office, local hospital, or county health department. You are responsible for any expenses incurred. You must agree to and sign a release for information to be reported to the program director relating to exposure follow-up testing and/or treatment for blood and/or body fluid exposure. All of this information will be treated in strictest confidence and shall be used solely to determine whether you should be removed from clinical rotation to protect the employees and/or athletes of the clinical site. 5. Professional Association Membership You are required to join the National Athletic Trainers’ Association as a student member during your time as an ATS at WLU. You may obtain an application online at www.nata.org. Questions regarding these organizations should be addressed to the program director. 97 I. Disciplinary Procedures With the exception of the circumstances described in Section I1, the following process will be used for disciplinary matters. The purpose of this process is to correct your behaviors so that you can successfully complete the program. The following list contains examples of inappropriate behaviors that may result in disciplinary procedures: 1. Cheating or plagiarism 2. Dress code violations 3. Excessive tardiness 4. Failure to report an absence 5. Insubordination 6. Failure to maintain academic or clinical proficiency 7. Under the influence of alcohol or drugs in an academic setting 8. Abusive language 9. Performing the duties of an athletic trainer without the direct supervision of a preceptor 10. Falsifying clinical attendance records 11. Failure to maintain proper hygiene 1. First Offense: Student is given an oral reprimand and expected to make immediate changes. A written account is filed in the student’s record. 2. Second Offense: Written documentation of the offense is given to the student. The student will be deferred to university administration for reprimand and university policy will ensue. Any missed time must be made up. A written report is placed in the student’s permanent file. The student may be placed on probation within the athletic training program at the discretion of the program director. 3. Third Offense: Written documentation of the offense is given to the student. The student is then permanently dismissed from the program, and a written report is placed in the student’s permanent file. The student situation will be handled at the university level, and the student will no longer be permitted to be a part of the athletic training program. a. Permanent Dismissal from a Clinical Site You may be permanently dismissed from a clinical site for unsafe clinical practice any time during the semester. In such cases a grade of “F” will be given for the course in which the unsafe practice occurred, and you will be permanently dismissed from the program. Reasons for unsafe clinical practice include, but are not limited to, the following: 1. Failure to attain the required level of cognitive or motor skills 98 2. Inadequate preparation 3. Inaccurate documentation 4. The inability to perform motor skills safely 5. Violation of institutional or professional codes of conduct 6. Unethical/Unprofessional behavior 7. Under the influence of drugs or alcohol 8. Inability to establish rapport with patients or staff 9. Lack of integrity, initiative, interest, or dependability You will be afforded due process according to West Liberty University policy in cases of dismissal for unsafe practice. If you choose to appeal the decision, the Clinical Coordinator will keep you out of the clinical areas until the appeal process is completed. If the results of the appeal allow you to remain in the course, you will be given the opportunity to make up the clinical time. 99 J. NATA Code of Ethics PREAMBLE The National Athletic Trainers’ Association Code of Ethics states the principles of ethical behavior that should be followed in the practice of athletic training. It is intended to establish and maintain high standards and professionalism for the athletic training profession. The principles do not cover every situation encountered by the practicing athletic trainer, but are representative of the spirit with which athletic trainers should make decisions. The principles are written generally; the circumstances of a situation will determine the interpretation and application of a given principle and of the Code as a whole. When a conflict exists between the Code and the law, the law prevails. PRINCIPLE 1: Members shall respect the rights, welfare and dignity of all. 1.1 Members shall not discriminate against any legally protected class. 1.2 Members shall be committed to providing competent care. 1.3 Members shall preserve the confidentiality of privileged information and shall not release such information to a third party not involved in the patient’s care without a release unless required by law. PRINCIPLE 2: Members shall comply with the laws and regulations governing the practice of athletic training. 2.1 Members shall comply with applicable local, state, and federal laws and institutional guidelines. 2.2 Members shall be familiar with and abide by all National Athletic Trainers’ Association standards, rules and regulations. 2.3 Members shall report illegal or unethical practices related to athletic training to the appropriate person or authority. 2.4 Members shall avoid substance abuse and, when necessary, seek rehabilitation for chemical dependency. PRINCIPLE 3: Members shall maintain and promote high standards in their provision of services. 3.1 Members shall not misrepresent, either directly or indirectly, their skills, training, professional credentials, identity, or services. 3.2 Members shall provide only those services for which they are qualified through education or experience and which are allowed by their practice acts and other pertinent regulation. 3.3 Members shall provide services, make referrals, and seek compensation only for those services that are necessary. 100 3.4 Members shall recognize the need for continuing education and participate in educational activities that enhance their skills and knowledge. 3.5 Members shall educate those whom they supervise in the practice of athletic training about the Code of Ethics and stress the importance of adherence. 3.6 Members who are researchers or educators should maintain and promote ethical conduct in research and educational activities. PRINCIPLE 4: Members shall not engage in conduct that could be construed as a conflict of interest or that reflects negatively on the profession. 4.1 Members should conduct themselves personally and professionally in a manner that does not compromise their professional responsibilities or the practice of athletic training. 4.2 National Athletic Trainers’ Association current or past volunteer leaders shall not use the NATA logo in the endorsement of products or services or exploit their affiliation with the NATA in a manner that reflects badly upon the profession. 4.3 Members shall not place financial gain above the patient‘s welfare and shall not participate in any arrangement that exploits the patient. 4.4 Members shall not, through direct or indirect means, use information obtained in the course of the practice of athletic training to try to influence the score or outcome of an athletic event, or attempt to induce financial gain through gambling. 101 K. STUDENT POLICIES AGREEMENT (To the student: After carefully reading this page, print and complete the required information. Sign it and return it to the clinical coordinator or program director.) I, the undersigned, have read, received an explanation of, and understand the guidelines contained in this handbook. I also understand that I must comply with and follow these guidelines and policies during the period of my enrollment as an Athletic Training Program student at West Liberty University. In accordance with West Liberty University’s clinical affiliation agreement, I grant permission for West Liberty University’s athletic training program faculty to discuss both my academic standing and clinical progression with any or all of the program’s clinical affiliates. DATE SIGNATURE PRINTED NAME I, the undersigned, give West Liberty University my permission to release my medical records to clinical sites as necessary. DATE SIGNATURE SOCIAL SECURITY # 102